BY SIGNING THIS DOCUMENT I HEREBY WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE ANN’S HEART AND GOOD SAMARITAN SERVICES, EACH A PENNSYLVANIA NOT-FOR-PROFIT CORPORATION.

 Activity: Phoenixville Bed Races

Date of Activity: November 7, 2026

I desire to participate in the Phoenixville Bed Races (the “Activity”), for which I may construct a bed, and/or act as a “pusher” or “rider” of such a bed in the race. “Pushers” must be a minimum age of fifteen (15) years old and “Riders” must be a minimum of thirteen (13) years old. In consideration of being permitted to participate in the Activity, I hereby agree to all the terms of this Release of Liability and Waiver of Rights (“Release”).

This Release shall be binding upon and enforceable against me, my personal representatives, spouse, assigns, heirs, and next of kin without limitation. It is my desire and intent that this Release shall be enforceable to the fullest extent permitted by law. If any portion of this Release is held invalid, the remainder shall not be affected and shall continue in full legal force and effect. The terms of this Release shall continue from this date forever. This document constitutes the entire agreement regarding my participation in the Activity. I hereby agree as follows: 

Assumption of Risk

My choice to participate in the Activity is knowing and voluntary. I understand and agree that there is a significant risk of injury from participating, including, but not limited to, risk of injury from building the bed, pushing the bed, and racing the bed. Such injuries could be serious, permanent or progressive, even resulting in death. 

Release from Liability

I fully and forever release and discharge Ann’s Heart and Good Samaritan Services and their respective directors, officers, shareholders, employees, agents, volunteers, and insurers (collectively referred to as “Sponsors”), from any and all injuries (including death), losses, damages, claims, demands, lawsuits, expenses, and any other liability of any kind, of or to me, my property, or any other person, arising out of my participation in the Activity. 

Covenant Not to Sue

I will not initiate any claim, or legal proceeding or demand against Sponsors, nor join or assist in the prosecution of any claim for money or other damages which anyone may have on account of injuries (including death), losses, or damages sustained by me, other parties, or my (or others') property in connection with my participation in the Activity, and I waive any right to do so. I waive my insurers' right to make a claim against Sponsors based on payments by insurers to me or on my behalf due to my participation in the Activity. This means my insurers have no rights of subrogation against Sponsor. 

Medical Expenses

I hereby consent to receive medical treatment which may be deemed necessary resulting from or in connection with my participation in the Activity and I understand that I am solely responsible for all costs related to such medical treatment, medical transportation and/or evacuation. 

Representations

I am in good health, in proper physical condition, and I do not have any medical or other conditions that would impair my ability to participate in the activity. 

Publicity

I hereby grant Sponsors, without limitation, the right to use my name and likeness in connection with the Activity for any publicity without further compensation or permission.